<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
    <div class="form-group">
        <label for="c-mobile" class="control-label col-xs-12 col-sm-2">{:__('手机号')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mobile" data-rule="required" class="form-control" name="row[mobile]" type="text" value="{$row.mobile|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">姓名:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-name" data-rule="required"  class="form-control" name="row[name]" type="text" value="{$row.name|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">领取次数:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-cishu"  class="form-control" name="row[cishu]" type="text" value="{$row.cishu|htmlentities}" placeholder="留空代表不限制">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('有效期')}:</label>
        <div class="col-xs-12 col-sm-4">
            <input id="c-time_beg" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm"  name="row[start_time]" type="text" value="{$row.start_time|htmlentities}" placeholder="留空代表不限制">
        </div>
        <label class="col-sm-2  col-sm">-</label>
        <div class="col-xs-12 col-sm-4">
            <input id="c-time_begs" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm"  name="row[end_time]" type="text" value="{$row.end_time|htmlentities}" placeholder="留空代表不限制">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('备注')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-remarks" data-rule="required" class="form-control " rows="5" name="row[remarks]" cols="50">{$row.remarks|htmlentities}</textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
        <div class="col-xs-12 col-sm-8">
            {:build_radios('row[status]', ['1'=>__('Normal'), '0'=>__('Hidden')], $row['status'])}
        </div>
    </div>

    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
<style>
    .col-sm{
        width: 0%;
        top: 4px;
    }
    #l-map{height:450px;width:100%;}
    #r-result{width:100%; position: absolute; top: 10px; left: 10px}
    #maps{position: relative}
</style>
